Effectiveness of a medical polyvalent Day Care Hospital: evaluation of the reduction of hospitalizations and days of hospitable stay: a before-and-after study

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Day Care Hospitals (DCH) are medical healthcare units where are attended patients that need diagnostic methods or treatments that last a few hours of attention, but that do not need to be hospitalized. “Hospital Universitari de Vic” has recently initiated a new project to improve the medical attention of the patients and to clear ...[+]

Day Care Hospitals (DCH) are medical healthcare units where are attended patients that need diagnostic methods or treatments that last a few hours of attention, but that do not need to be hospitalized. “Hospital Universitari de Vic” has recently initiated a new project to improve the medical attention of the patients and to clear up the contact between professionals. One of the pillars of the project is the opening of a medic DCH. There are few studies that evaluate the medical care and the profitability of DCH in Spain, but they have generally concluded that DCHs provide a reduction of pressure on the Emergency Room and on the Hospitalization Floor
Justification: This study is realized to evaluate the effectiveness of the opening of the DCH in Vic with the reduction of hospitalizations and the reduction of the time that patients are hospitalized. A lower number of hospitalizations implies a lower number of complications related to the hospitalizations, a lower sanitary expense and an improvement on the optimizations of the resources. This study will also provide data that could be interesting for the sanitary centers that want to open a DCH
AIMS: To describe the characteristics of the chronic patients (HF, chronic pneumopathies and LC) that are attended at the DCH. To determine the effect on the number of hospitalizations and hospitable stays of the patients with chronic advanced diseases (HF, CP, LC) with the functioning of the Day Care Hospital. To determine the real impact in the general number of medical hospitalizations in the HUV
Methods: This study has been realized with a before-and-after study, with the opening of the DCH in Vic as the main intervention. It has been realized in the medical DCH of the HUV with a sample of 78 subjects, which have been collected with a consecutive no-probabilistic sampling of the patients that have been attended in the DCH of the HUV Demographic, clinical, diagnostic and treatment data of the patients have been collected. The number of hospitalizations, hospitable stays and attentions to the Emergency Room has also been collected during a period of time that has been equal between the after and the before period of the DCH opening. The hospitalizations and the hospitable stays during the months of DCH functioning have been compared with the same period of the 2 previous years (2013 and 2014). The statistical analysis has been realized with the SPSS statistical package v21.0
Results: The most frequent attended disease was heart failure, with the 50% of prevalence in the DCH. It has been detected a borderline statistical significance of the reduction of medical hospitalizations compared to the previous two years, when the DCH wasn’t working
Conclusion: The medical Day Care Hospital in Vic has reduced the number of hospitalizations and hospitable stays of the attended patients during the six months that has been working[-]